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Masks have a practical problem

By Tim Kalich , READ MORE > 793 Reads
On Mon, 07/27/2020 - 10:30 AM

With face masks a major focus these days in the fight against — and about — the COVID-19 pandemic, I’ve been trying to educate myself about them.

Mississippi Gov. Tate Reeves is all for masks, even though he’s slipped up a time or two by not following his own advice. He’s been imploring people in this state for weeks to wear one, in addition to regularly washing their hands, avoiding large crowds and practicing social distancing. He remains reluctant, however, to mandate facial coverings except in counties identified as major hot spots in the latest surge in COVID-19 cases. So far he’s targeted 13 counties, although he indicated Friday that another 11 could be added by Monday.

Even though 28 states, including three of Mississippi’s neighbors, have implemented statewide mandates for masks, Reeves has stuck by a targeted approach in an effort to soften the backlash from conservatives who resent government dictates on personal behavior.

While the Republican governor walks that political tightrope, he sometimes gets the primary justification for masks backward. It’s really not that wearing one — or at least wearing the type we’re told to wear — will protect you from catching the disease. It’s that wearing one could prevent you from unknowingly giving the illness to someone else.

My concern is not that the government mandates, such as those ordered by local officials in Greenwood and Leflore County, are overreaching. My worry is that they won’t do all that much good.

Here’s why.

Initially, COVID-19 was believed, like the flu, to be spread almost exclusively by droplets, which, after leaving the infected person’s mouth or nose, would drop to the ground in short order. Thus, the 6-foot rule.

To stop these droplets from getting even that far, the cloth and disposable masks that most of us are wearing appear to work fine.

What they’re not good at, though, is impeding the tinier aerosols, which a growing body of research suggests is another way that COVID-19 is transmitted. Viral aerosols travel farther and stay in the air longer than droplets. They not only can penetrate the fibers in standard masks, they also can get around wherever there is not a tight fit between the mask and the skin.

The only type of masks that can stop the exhalation and inhalation of aerosols are N95s, which we are told are still in such short supply that they need to be reserved for hospital and nursing home workers and other health care providers who come into close contact with those who are infected with COVID-19

Even though there are some websites where an individual can purchase N95s, that creates a moral dilemma of whether buying those up could be seen as just as selfish and potentially as life-threatening to others as refusing to wear a mask.

Some in the medical community have argued that the federal government, just as it did with ventilator production during the early stages of the outbreak, needs to compel domestic manufacturers to ramp up production of N95 masks to both eliminate the shortages at medical facilities and also supply the general public.

Why that hasn’t happened, even without a government mandate, involves a mixture of causes. Part of the reason is that the global demand for these masks has exploded so much that it’s going to take time for the supply chain to catch up. Part of it is that production of N95s, as with a lot of durable goods consumed in this country, was shifted years ago overseas, and those countries, naturally so, are worried first about taking care of themselves before they worry about taking care of us. And part of it is that the thin filter in the middle of N95s is made by a complex piece of equipment, of which there are only so many in existence, and making new machines to crank out this filter material apparently takes months.

But even if N95s could be mass-produced in sufficient quantity to fit everyone, would Americans wear them correctly and religiously? It’s doubtful, not just because of ideological resistance but more so because these professional-grade masks get uncomfortable over long stretches of time.

N95s are effective not only because of their filter, but because they are airtight. That lack of air circulation keeps viruses out of a person’s airways, but it also makes the wearer’s skin hot and sweaty. People may endure that discomfort while they are shopping in a store, but it’s hard to see them doing so all day at work.

Convincing people to wear the airier cloth or disposable masks is more doable, but it’s also a porous strategy. Nearly 100% of the people have to wear them and wear them correctly to stop widespread transmission of the virus. No pulling the masks down under the nose or wearing them as useless chin guards, as many are wont to do.

Such universal compliance, even with increasing social pressure and expanding government mandates, may be an exercise in futility.

n Contact Tim Kalich at tkalich@gwcommonwealth.com.

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